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Do You Shake? Essential Tremor Used to Be Called Benign Familial Tremor - The Scoop

Updated on August 28, 2016

Coping is the Norm

Millions of people, like me, my sister, and my grandmother shake all the time. Only 10% of them seek medical attention. For me, essential tremor (ET) means people think I'm nervous when I'm fine. ET means having to lean over my bowl of soup to get a spoonful to my mouth without spilling soup in my lap. If I get angry or afraid, I actually quake. When I used to sew up lacerations of skin, though, my work was unaffected. I got great cosmetic results. This is born out by practicing neurosurgeons who have learned to compensate for their tremors.

Essential tremor does tend to run in families. It can come on at any age including childhood. It tends to worsen and may get coarser with advancing age. You can see this age effect in Kathryn Hepburn in "On Golden Pond." This tremor can affect arms, legs, head, and voice. Alcohol lessens the shaking. No one knows the exact cause, but the fact that deep brain stimulation (a last resort surgical operation in severe cases) works to quiet ET is telling of an origin in the brain.

The International Essential Tremor Foundation ( offers information and helpful gadgets such as plates with bumpers. They are also advocating for an Essential Tremor Awareness Month to be designated by the U.S. congress.

Caffeine and nicotine worsen this tremor. Relaxation, meditation, and other stress reduction techniques may help.

The first-line meds for folks who decide they'd be happier with less tremor are inderal (a BP med), mysoline (a seizure med), and topiramate (a migraine treatment). Sometimes helpful is gabapentin, another seizure drug. It takes fairly high doses to improve ET, so side effects are an issue. Sometimes a combination is used to minimize side effects. Benzodiazepines such as Ativan and Klonopin are effective, but not the drugs of choice as they are addictive. As mentioned above, alcohol is effective and a couple drinks can be used to lessen ET for a special occasion. Alcohol is not recommended as a long-term treatment as it has lead to alcoholism in ET sufferers.

As of 2016, a new procedure is available for severe ET. High intensity ultrasound waves destroy one side of the thalamus (a communication center in the brain). Tremor tends to be improved to the point where quality of life is improved. It, however, is irreversible and can be associated with side effects such as gait disturbances.

I have been asked if I have Parkinson's Disease. I'm sure I don't. Parkinson's tremor occurs at rest and is accompanied by muscle stiffness and slowness. Essential tremor occurs while holding a posture or moving and has no accompanying symptoms.

Another common type of tremor is enhanced physiological tremor. Causes include overactive thyroid, medications (including antihistamines, lithium, and antipsychotics), muscle fatigue, and anxiety.


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    • profile image

      Gracelin 3 years ago

      And I thought I was the sensible one. Thanks for setting me stitgrha.

    • cathylynn99 profile image

      cathylynn99 3 years ago from northeastern US

      thanks for reading and commenting, cynthia.

    • techygran profile image

      Cynthia 3 years ago from Vancouver Island, Canada

      cathylynn99 thank you for a very clearly-written and easy-to-understand article about a condition that I personally see more and more often among friends and acquaintances in my 'boomer' generation. I had always assumed that the tremor WAS Parkinsons until a close friend described his struggles with ET. He was a celebrated church organist and now, as he heads towards 70, contents himself with frustrating sessions on his livingroom organ only. It's a shame.

      I think an awareness "day" is a great idea because I am guessing that Essential Tremors are pretty wide-spread and misunderstood as our populations age.

      Thank you for posting this valuable hub. ~Cynthia

    • cathylynn99 profile image

      cathylynn99 4 years ago from northeastern US

      essential tremor is not associated with any mental illness.

    • Marie Flint profile image

      Marie Flint 4 years ago from Jacksonville, Florida USA

      I personally never had a tremor problem. My father-in-law, however, had signs of it and he took his wife's valium to lessen the shakes. (I reprimanded him for using others' medications, but it didn't o any good; he also kept drugs way beyond their expiration date.)

      I think mental types are more prone to this problem, perhaps. Has anyone tried going entirely organic with their diet?


    • cathylynn99 profile image

      cathylynn99 4 years ago from northeastern US

      hi, chefsref,

      yep, good that they took benign out of the name, because this tremor can cause significant problems. thanks for reading and commenting.

    • chefsref profile image

      Lee Raynor 4 years ago from Citra Florida

      Good Hub.

      I seem to have some ET in my family. I remember when my grandmother was alive, if she drank a cup of coffee the cup would actually rattle against her teeth. I thought it was funny as a kid but now I must have inherited it. At times it is very difficult to sign my name legibly.

    • cathylynn99 profile image

      cathylynn99 6 years ago from northeastern US

      thanks, ginger.

      i wouldn't let anyone diagnose me with parkinsons. i'm far too assertive and knowledgeable. it's good advice in general, though. thanks again.

    • profile image

      Ginger Ruffles 6 years ago

      Informative hub. Runs in our family as well. It's so important to know that a Parkinson's tremor occurs at rest while ET occurs when trying to do something.

      Also if you need a Neurologist please get a MD referral from the ET Foundation. Too many doctor's are unknowledgeable about this condition and will diagnose this as Parkinson's as my elderly father has been. Trust me it's a nightmare you don't want or need.

    • cathylynn99 profile image

      cathylynn99 6 years ago from northeastern US

      there's still mysoline and topiramate or even the occasional ativan for a special function (say a speech or a daughter's wedding). otherwise, coping, as it sounds he is creatively doing, is a good strategy.

      thanks for reading.

    • profile image

      Liasis1 6 years ago from Nashville

      My husband has ES, it runs in the males in his family.

      Recently I began seeing a neurosurgeon who is now running a pain clinic. He's a well-respected dr, even was on-call physician to a few presidents. On my first visit he dxd me with Sticky Blood & told me I was on the verge of another stroke. Lab tests bore his dx out. I mentioned my husband's tremor to him & he asked to see him.

      Today my husband saw Dr Y for the first time. He was amazed at the way this dr could tell him about his symptoms before he ever mentioned them!

      My husband is bipolar & takes saphris, which Dr. Y told him to stop immediately. He (my husband) is on all kinds of other meds, cholesterol, triglyceride, bipolar & blood pressure. He was told by his PCP that Inderal (I took it to prevent migraines, it was a nightmare med for me) would interact badly with his other meds, so now it seems to be a choice between tremors or high triglyceride.

      Also, he has noticed the tremors are worse on his dominant side (he's left-handed), & is learning to eat with his right hand. It actually seems to be working well for him.

    • cathylynn99 profile image

      cathylynn99 7 years ago from northeastern US

      March 2011 is the first ever national essential tremor awareness month.

    • cathylynn99 profile image

      cathylynn99 7 years ago from northeastern US

      dear happyboomernurse,

      sounds like you had enhanced physiological tremor caused by anxiety. your common sense measures will help others.

      dear magnoliazz,

      thanks for the compliment and especially for reading

    • magnoliazz profile image

      magnoliazz 7 years ago from Wisconsin

      ETs run in my family also, I remember Aunt Mabel shook all the time... she was a great source of interest to us when we were small children.

      Excellent hub!

    • Happyboomernurse profile image

      Gail Sobotkin 7 years ago from South Carolina

      I had tremors when I was in my twenties, thirties and forties, but rarely have them anymore. They seemed to be related to anxiety and stress and through the decades I've learned how to cope with stress and anxiety by using meditation, physical excercise and limiting caffeine intake.

      Thanks for sharing this informative article.

    • cathylynn99 profile image

      cathylynn99 7 years ago from northeastern US

      if you like the hub, hit the "up" button at the end of the hub. it's like thumbs up. well, employed or not, you are contributing tips that will help others. are you on "linked in", the internet employment network? you could register on hubpages and write here, too. i've yet to make money here, but it's a good outlet. oh, there is a link to facebook with a "like" button at the top af the hub, at least there is on mine.

    • profile image

      Steven Levine 7 years ago

      (above message was supposed to say "a 'Like' button." I put the word between less than/greater than symbols (as I commonly do on Facebook), and apparently it got stripped as being bad HTML.)

    • profile image

      Steven Levine 7 years ago

      Thanks for the kudos, cathylynn99 (this site needs a button). I'd be more of a survivor and a champion if I were employed and not borderline indigent, but I guess that's off topic.

      You can thank my sister for the travel mug idea. She got it for me a couple years ago, and it has been a great relief, along with a Tupperware-type container with tight-fitting lid for carrying soup, etc.

    • cathylynn99 profile image

      cathylynn99 7 years ago from northeastern US

      bravo to you, steven. sounds like you're more than a survivor, more like a champion. thanks for the travel mug coping tip, too.

    • profile image

      Steven Levine 7 years ago

      I find your mention of "practicing neurosurgeons who have learned to compensate for their tremors" to be very interesting. I've had E.T. since childhood, and I'm unable to drink coffee in public (except in a travel mug), and yet I'm able to type 36 wpm using only six fingers, which is quite amazing.

    • cathylynn99 profile image

      cathylynn99 7 years ago from northeastern US

      sorry, Diogenes. I wasn't clear. i edited the hub to show that meds cause a different kind of tremor - enhanced physiological, which can occur on its own or make ET worse.

      yes, Me Too, stimulants can cause or exacerbate tremor.

    • profile image

      Me Too 7 years ago

      I sometimes take Modafinil. It definitely increases the shaking. On the other hand Modafinil shows positive effects in Parkinson's patients against nerve degeneration.

    • diogenes profile image

      diogenes 7 years ago from UK and Mexico

      Interesting. Some medications may also cause or worsen this? I have a friend on anti-depressants whose hands have begun to shake...I don't think it can all be caused by excitement at seeing me! Bob


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